Health Record Requirements

Prior to entering Western Connecticut State University, all full-time students are required to submit a completed Health Form, which includes a physical examination and a Tuberculosis (TB)  Risk Assessment to the Health Service.

The physical examination must be completed no earlier than one year prior to entering the University. The Tuberculosis Risk Assessment, (Part D of the Health Record) must be completed and reviewed by your health care provider and the TB Testing Evaluation completed as required.

These requirements are the responsibility of the student.  Failure to meet these requirements, will prevent you from registering for the following semester.

Follow this link to download a printable version of the Connecticut State University Health Form and Guidelines for completing this form.


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